摘要
【目的】探讨食管原发性恶性黑色素瘤（PM M E ）的影像学、临床病理学特征，诊断、鉴别诊断及治疗。【方法】回顾性分析5例PM M E患者的临床资料，结合相关文献对其临床表现、影像学、组织形态和免疫组化特点及治疗和预后等进行分析。【结果】5例患者均为老年男性，平均年龄63．4岁，均表现为进食不畅，症状呈进行性加重。胃镜检查示：3例距门齿25～35 cm食管前壁及左侧壁见不规则结节状肿物及息肉样肿物，2例距门齿35～40 cm食管右侧壁及右后壁见不规则溃疡型肿物。C T检查显示：食管中、下段管腔内偏心性肿瘤，增强扫描5例肿瘤均有强化，其中1例病灶强化均匀，其余4例呈不均匀强化。肿瘤病理组织学表现：瘤细胞排列呈巢片状或条索状，细胞圆形或多角形，胞质丰富红染，胞质内见黑色素颗粒，细胞核大小不一，核居中或偏位，核仁明显，病理性核分裂象易见。免疫表型：瘤细胞弥漫表达HMB‐45、Melan A、S‐100；CK阴性，Ki‐67阳性细胞数30％～35％。【结论】食管原发性恶性黑色素瘤非常罕见，有特征性的影像学、组织学、病理学特点，有助于该肿瘤诊断。
[Objective] To explore the clinicopathologic characteristics ,diagnosis ,differential diagnosis and treatment of primary malignant melanoma of esophagus （PMME） .[Methods]Light microscopy and immunohisto‐chemistry were used to examine 5 male cases of PMME .With a review of the relevant literature ,their clinical manifestations ,radiographic ,histological ,immunohistochemical characteristics ,treatment and prognosis were an‐alyzed .[Results] Their mean age was 63 .4 years .All had a progressive dyaphagia .Histopathologically ,tumor cells were round or polygonal nests ,cords or flakes .Abundant red dye and melanin granules were visible within cytoplasm .Nucleus sizes varied and prominent nucleoli were centered or deviated .Pathological mitosis was noticeable .Immunohistochemical staining showed that tumor cells were positive for HMB‐45 ,Melan A and S‐100 and negative for CK .The Ki‐67 positive rate was 30% ～35% .[Conclusion]PMME is quite rare and yet highly malignant With a poor prognosis .Immunohistochemical staining helps its diagnosis and differential diagnosis from other poorly differentiated tumors such as carcinosarcoma ,esophageal lymphoma ,neuroendocrine carcinoma and leiomyoma of esophagus .
出处
《医学临床研究》
CAS
2015年第4期748-750,共3页
Journal of Clinical Research
